From Family Preservation Services Provider / Agency
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Reason for Submission: (Check the applicable boxes below
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☐ Drug Toxicology Results/Pregnant Woman Using Substances referral to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4205.docx
State of Kansas Department for Children and Families Prevention and Protection Services Family Preservation Services Acknowledgment of Referral / Change / Closure PPS 4205 REV
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4205.pdf